Provider Demographics
NPI:1104087840
Name:WOLF, WILLIAM MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:WOLF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:JANE
Other - Middle Name:ANN
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SECRETARY
Mailing Address - Street 1:3999 RICHMOND RD
Mailing Address - Street 2:HARRINGTON HEART AND VASCULAR INSTITUTE
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6046
Mailing Address - Country:US
Mailing Address - Phone:216-593-1303
Mailing Address - Fax:216-593-1301
Practice Address - Street 1:3999 RICHMOND RD
Practice Address - Street 2:HARRINGTON HEART AND VASCULAR INSTITUTE
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6046
Practice Address - Country:US
Practice Address - Phone:216-593-1303
Practice Address - Fax:216-593-1301
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431601207RC0000X
OH35-095506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3071956Medicaid
OHP00870915Medicare PIN
OH3071956Medicaid